Diagnostic Cytopathology最新文献

{"title":"Improving Peritoneal Staging in Gastric Cancer: Time to Move Past Cytology Alone.","authors":"Eoghan Burke","doi":"10.1002/dc.70029","DOIUrl":"https://doi.org/10.1002/dc.70029","url":null,"abstract":"","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Prognostic Features of Malignant Thyroid Nodules With Atypia of Undetermined Significance Cytology: Evaluation of Nuclear Atypia-Based Subgroups.","authors":"Yusuf Öztürk, Naile Kökbudak, Muhammet Kocabaş, Melia Karaköse, Mustafa KulaksizoĞlu, Feridun Karakurt","doi":"10.1002/dc.70027","DOIUrl":"https://doi.org/10.1002/dc.70027","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the clinical and prognostic characteristics of thyroid nodules that were initially diagnosed as atypia of undetermined significance (AUS) and subsequently confirmed as malignant following surgery. The study also aimed to investigate their subclassification based on nuclear atypia.</p><p><strong>Methods: </strong>Patients who underwent thyroid surgery and were diagnosed with differentiated thyroid carcinoma between January 2016 and December 2024, and who had undergone a preoperative fine-needle aspiration biopsy (FNAB), were categorized retrospectively into three groups based on their cytological classification: AUS, suspicious for malignancy (SFM) and malignant (M). The clinicopathological and prognostic characteristics of these groups were then compared. Patients in the AUS group were also categorized according to the presence of nuclear atypia for further analysis.</p><p><strong>Results: </strong>Of the 775 patients, 11.7% were assigned to the AUS group, 35.1% to the SFM group, and 53.2% to the M group. Nodules in the AUS group were significantly smaller in diameter and exhibited fewer invasive features compared to those in the SFM and M groups (p < 0.05). The M group showed higher rates of advanced TNM staging, lymph node metastasis, and distant metastasis. Patients in the AUS group demonstrated the highest proportion of low-risk classification (93.4%) and the highest rate of excellent response to therapy (96.7%), with no observed recurrence or progression. No significant differences in invasiveness were found between AUS-nuclear atypia (AUS-N) and AUS-other atypia (AUS-O) subgroups, both of which exhibited similarly indolent profiles.</p><p><strong>Conclusion: </strong>Malignant nodules diagnosed as AUS exhibited an indolent course and an excellent prognosis. Our findings suggest that less aggressive, more individualized treatment strategies should be considered for AUS cases, and emphasize the potential prognostic value of nuclear atypia-based subclassification.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TFE3-Rearranged PEComa(-Like Neoplasm) of the Chest Wall Diagnosed by Fine-Needle Aspiration: A Case Report.","authors":"Shah Dev, Matthew Miller, Tom Hu, Cindy McGrath, Roseann I Wu","doi":"10.1002/dc.70026","DOIUrl":"https://doi.org/10.1002/dc.70026","url":null,"abstract":"<p><p>We report a rare TFE3-rearranged perivascular epithelioid cell tumor (PEComa) of the parasternal chest wall diagnosed preoperatively by fine-needle aspiration (FNA) cytology. The smears and cell block showed epithelioid cells with clear to granular cytoplasm and prominent nucleoli. Immunohistochemistry (IHC) demonstrated strong nuclear TFE3 expression and melanocytic marker positivity (diffuse HMB-45, focal Melan-A) with absent smooth muscle marker staining. FISH confirmed a TFE3 rearrangement, and next-generation sequencing identified an SFPQ:TFE3 fusion. The integrated cytologic and molecular workup enabled definitive classification as a TFE3-rearranged PEComa before surgical resection. This case highlights the diagnostic utility of cytologic material for translocation-associated neoplasms and the importance of molecular subtyping for prognosis and treatment.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Fine Needle Aspiration Biopsy and Rapid Onsite Evaluation in the Diagnosis of Kidney Lesions.","authors":"Zehra Şahin, Şenay Erdoğan Durmuş, Deniz Ünlüer Kapışkay, Ahmet Baş, Nesrin Uygun","doi":"10.1002/dc.70025","DOIUrl":"https://doi.org/10.1002/dc.70025","url":null,"abstract":"<p><strong>Background: </strong>Although core needle biopsy is widely preferred for evaluating renal lesions, fine needle aspiration (FNA) combined with rapid on-site evaluation (ROSE) remains a valuable diagnostic method in selected cases. This study aims to assess the diagnostic efficacy of renal FNA and highlight the impact of ROSE on achieving definitive diagnoses.</p><p><strong>Methods: </strong>This retrospective study included 273 patients who underwent ultrasound- or CT-guided FNA for renal lesions between 2010 and 2018 at Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine. Lesions were evaluated based on size, radiologic features, localization, ROSE status, and number of smears. Cytopathological results were categorized as nondiagnostic, limited, non-neoplastic, or neoplastic. Histopathological correlation was assessed in available cases. Statistical analyses were performed using SPSS v25.0, with p < 0.05 considered significant.</p><p><strong>Results: </strong>Of the 273 cases, 218 (79.8%) yielded diagnostic results. Definitive diagnosis rates increased with lesion size and were significantly higher in solid (86.3%) and mixed (91.4%) lesions compared to cystic lesions (60%) (p = 0.001). ROSE was performed in 177 cases, significantly improving diagnostic yield compared to cases without ROSE (85.8% vs. 68.7%, p = 0.001). Histopathological follow-up was available in 119 cases, with an overall cytological-histological concordance of 84%, reaching 98% in cases with adequate material.</p><p><strong>Conclusion: </strong>Renal FNA remains a reliable and accurate diagnostic method when combined with ROSE, especially in well-sampled cases. It aids in identifying both primary and metastatic tumors and can guide clinical decision-making, particularly when surgery is not feasible.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing Thyroid Lesions Through A Morphology-Molecular Lens: Four Case-Based Lessons From 22nd International Congress of Cytology-Florence 2025.","authors":"Sule Canberk, N Paul Ohori, Rita Luis, Elena Vigliar, Vivian Weiss, Zubair Baloch","doi":"10.1002/dc.70022","DOIUrl":"https://doi.org/10.1002/dc.70022","url":null,"abstract":"<p><p>Imaging-driven detection of thyroid nodules has expanded the role of fine-needle aspiration (FNA) while demanding integration of molecular data into routine cytologic assessment. We present four illustrative cases spanning the contemporary diagnostic spectrum: (1) an Atypia of Undetermined Significance (AUS) nodule with dual low-level PTEN mutations managed by active surveillance; (2) an oncocytic follicular neoplasm upgraded to total thyroidectomy by concurrent HRAS and TERT promoter mutations; (3) an oncocytic subtype poorly differentiated thyroid carcinoma (O-PDTC) highlighting subtle high-grade cytologic cues and a distinct genomic profile; and (4) a pediatric poorly differentiated carcinoma harboring a DICER1 hotspot mutation, underscoring age-specific biology and the need for genetic consideration. These cases emphasize that morphology remains foundational, but mutation context, single versus co-alterations, allelic burden, and patient age ultimately direct management. Harmonized reporting that clearly conveys molecular findings is essential to translate limited cytology material into precise, patient-specific care.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Pitfalls to Diagnosing NUTM1-Rearranged Neoplasia of the Pancreas by Cytology and Ancillary Studies.","authors":"Terrance J Lynn","doi":"10.1002/dc.70021","DOIUrl":"https://doi.org/10.1002/dc.70021","url":null,"abstract":"<p><p>Fine-needle aspiration cytology specimens are frequently utilized for ancillary studies to identify diagnostic and prognostic information. This case highlights diagnostic pitfalls and challenges in diagnosing NUTM1-rearranged neoplasia on pancreatic cytology. NUT carcinomas and sarcomas have highly variable cytomorphology, immunohistochemical staining profiles, and various gene partners involved in the fusion. Detecting these clinically relevant gene fusions in cytologic specimens can be particularly challenging as new diagnostic entities emerge. In cytologic specimens with a wide differential, maximizing the tissue for ancillary studies and selecting appropriate studies are critical. Finally, it highlights the importance of molecular cytopathology for patient care in complex and rare fusion-driven entities and the need for orthogonal testing when results are discordant and unexpected.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Spectrum of Malignant Diagnoses in Cerebrospinal Fluid (CSF) Cytology in Both Pediatric and Adult Populations: A Single-Institutional Retrospective Review.","authors":"Nida Babar, Asif Loya, Sajid Mushtaq, Maryam Hameed, Usman Hassan, Mudassar Hussain","doi":"10.1002/dc.70020","DOIUrl":"https://doi.org/10.1002/dc.70020","url":null,"abstract":"<p><strong>Introduction: </strong>Positive cerebrospinal fluid (CSF) cytology remains a cornerstone and irreplaceable diagnostic modality for the indication of leptomeningeal dissemination by primary as well as metastatic malignancies. Identification of tumor cells is fundamental for institution of aggressive treatment, such as radiotherapy, intrathecal chemotherapy, or systemic therapies, and will help increase overall survival. We did a retrospective analysis of CSF cytology in our center of all samples diagnosed as positive for malignant cells from January 2001 to December 2024 to find out about the spectrum of malignancies being detected in CSF cytology.</p><p><strong>Methods: </strong>We searched the database of our Hospital from January 2001 to December 2024 and found 853 samples of CSF of different patients that were diagnosed as positive for malignant cells. All cases were reviewed independently by two cytopathologists, and no discrepancy was found.</p><p><strong>Results: </strong>The diagnostic spectrum included cases of metastatic solid and hematolymphoid malignancies as well as dissemination of primary CNS tumors to CSF. Out of 853 cases, 550 cases were of CSF involvement by blast cells, 132 were of metastatic carcinomas, 78 were of hematological malignancies other than lymphoblastic lymphomas, 82 were of primary CNS tumors involving CSF, and 11 were of various other malignancies, including a spectrum of round blue cell tumors and sarcomas.</p><p><strong>Conclusions: </strong>A broad spectrum of epithelial, mesenchymal, and hematolymphoid malignancies can be diagnosed on CSF cytology, and these are likely metastatic in origin. Hematolymphoid malignancies, especially lymphoblastic lymphoma in children, are most common. Likewise, metastatic carcinomas constitute the major bulk of the adult population.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Cytomegalovirus in EGFR-Mutated and Wild-Type Lung Adenocarcinoma: Detection in Cytological Smears and Associated Peripheral Immune Response.","authors":"Suzana Harabajsa, Paula Gršković, Ivana Grgić, Lana Gorenec, Snježana Židovec Lepej, Sonja Badovinac, Marko Jakopović, Silvana Smojver-Ježek, Petra Korać","doi":"10.1002/dc.70024","DOIUrl":"https://doi.org/10.1002/dc.70024","url":null,"abstract":"<p><strong>Background: </strong>Human cytomegalovirus (HCMV) has been proposed as a potential risk factor in lung cancer. This study aimed to investigate the relationship between the presence of HCMV in tumor cells and the immune response to HCMV in the peripheral blood of patients with EGFR-mutated and EGFR wild-type lung adenocarcinoma.</p><p><strong>Methods: </strong>DNA was extracted from 102 May-Grünwald-Giemsa-stained cytological smears (51 EGFR-mutated and 51 EGFR wild-type). HCMV presence in tumor cells was assessed by PCR targeting viral genes MIE and gB. The immune response to HCMV was evaluated in 80 corresponding peripheral blood samples using the QuantiFERON-CMV ELISA test. Statistical analysis was performed using the chi-square test, with significance p < 0.05.</p><p><strong>Results: </strong>HCMV MIE gene was detected in eight (15.7%) EGFR-mutated and one (2.0%) EGFR wild-type smear. The HCMV gB gene was identified in four (7.8%) EGFR wild-type smears and none of the EGFR-mutated smears. Immune response to HCMV was observed in 18 (62.1%) EGFR-mutated and 26 (50.9%) EGFR wild-type patients. Among those with detectable HCMV MIE, an immune response was found in two EGFR-mutated and one EGFR-negative patient. Among smears positive for HCMV gB, immune response was detected in three EGFR wild-type cases. One EGFR wild-type case showed no immune response despite the presence of HCMV gB.</p><p><strong>Conclusion: </strong>No clear association was observed between HCMV in lung adenocarcinoma cells and the immune response to HCMV in peripheral blood, regardless of EGFR gene mutation status.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytopathology in the Philippines: A Chronicle of Practice, Purpose, and Progress.","authors":"Zubair Baloch","doi":"10.1002/dc.70023","DOIUrl":"https://doi.org/10.1002/dc.70023","url":null,"abstract":"","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Depth Assessment of Cytologic Features in 106 Cervical Papanicolaou Tests of Transgender Male Patients on Testosterone: An Institutional Experience.","authors":"Juanita E Ferreira, Nikki Chiang, Xin Jing, Brian Smola, Richard L Cantley, Judy C Pang, Madelyn Lew","doi":"10.1002/dc.70018","DOIUrl":"https://doi.org/10.1002/dc.70018","url":null,"abstract":"<p><strong>Background: </strong>There is a decreased cervical cancer screening rate among female to male transgender (FTMTG) patients. Data on the distinct cytologic features present in cervical cytology (CC) of those on testosterone therapy is limited.</p><p><strong>Methods: </strong>An 2017-2023 electronic database search identified CC specimens from a cohort of FTMTG patients on testosterone therapy (TT). A morphologic retrospective review of CC for cellularity and presence of key morphologic features was performed. Records were reviewed for original cytologic diagnoses and concurrent HPV test results for comparison with a cisgender female (CF) cohort.</p><p><strong>Results: </strong>106 of 132,363 (0.08%) identified CC specimens were from FTMTG patients on TT. Diagnostic rates were compared to the CF population. The most common diagnosis for both groups was \"negative for intraepithelial lesion or malignancy\". The unsatisfactory rate was significantly higher in the FTMTG cohort at 21.7% (vs. 2.7%). The comparative HPV positivity rate of FTMTG and CF cohorts was 13.2% and 10.7%, respectively. Of 83 FTMTG satisfactory CC specimens, 67% showed low cellularity (narrowly meeting the adequacy threshold of 5000 well-visualized squamous cells) and 78% showed extensive squamous atrophy. Nuclear grooves and irregular contours (features associated with transitional cell metaplasia) were observed in 18% and 23%, respectively. High N:C ratio was noted in 20% of cases.</p><p><strong>Conclusion: </strong>The higher unsatisfactory rate in FTMTG patients raises the question of whether adequacy criteria for this cohort should be adjusted. To enhance diagnostic accuracy, providing an accurate clinical history may prevent overinterpretation of features associated with transitional cell metaplasia.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}